Pharmacy reforms needed to boost Ireland’s pandemic preparedness

Posted on: 11 February 2025

Health system reforms to further integrate the community pharmacy sector are required to strengthen Ireland’s pandemic preparedness, according to new research conducted by health policy analysts from Trinity College Dublin.

Legislative changes to expand pharmacists’ roles, particularly during public health emergencies, are among the recommendations outlined in the new research published in the journal Qualitative Health Research.

The researchers also called for improved IT integration between pharmacies and the health system to facilitate the sharing of patient records.

The retrospective analysis of Ireland’s National COVID-19 Vaccination Programme involved stakeholder engagement, the review of 246 documents as well as interviews with eleven senior policy makers in the government and various parts of the health system.

Lead author Aaron Koay, who conducted the research while undertaking an MSc in Comparative Social Change in the School of Social Sciences and Philosophy in Trinity, explained:

“During the height of the COVID-19 pandemic, community pharmacies became the epicentre of primary care in Ireland when most health services, including GPs, switched to remote care.

“However, unlike some other high-income countries, community pharmacies in Ireland were involved relatively late in the COVID-19 vaccination programme – four months after GPs were engaged. This delay was even more puzzling since community pharmacies in Ireland had been providing various vaccination services for almost a decade, including the annual flu vaccine.

“Our research identified differing views on the reasons why there was such a delay in community pharmacists providing COVID-19 vaccination. Some attributed it to regulatory and logistical challenges, while others cited perceived doubts about the capability of community pharmacies to effectively and safely vaccinate the public.

“The study also highlights the lack of strategic direction within the pharmacist profession and lack of influence on national health policy — for example the Chief Pharmacy Officer post in the Department of Health has been vacant since 2013 and no pharmacy representative was present on the High-level Task Force on COVID-19 Vaccination.”

The research publication comes at a time when there is an important window for policy changes, according to the authors, with the formation last year of a review panel to evaluate the Government’s COVID-19 response.

The missed opportunity to engage community pharmacies earlier in providing COVID-19 vaccination to save lives should be part of the evaluation, advise the authors. While the Irish Government has recently committed to expanding the role of pharmacists in Ireland, the authors also cautioned against complacency because, as this research reveals, policy implementation can be obstructed or delayed.

Dr Camilla Devitt, Associate Professor in Sociology, in the School of Social Sciences and Philosophy, added:

“Our research is the first of its kind in the pharmacy practice sphere in Ireland. Through interviewing key policy elites and reviewing extensive documentary sources, we found that the implementation of community pharmacy-based COVID-19 vaccination in Ireland was far more than a technical exercise – it was a highly political process that involved several stakeholders and interests.

“Our research, like other previous studies, shows that the Irish health system is shaped by a diverse range of competing ideas, interests and institutions. Multi-method qualitative analyses like this one can reveal the closed, intricate workings of health policymaking to inform change towards better public health."

The full paper ‘What Obstructs Health Policy Implementation? A Multi-Method Qualitative Case Study of the Delayed Deployment of Community Pharmacies in Ireland’s National COVID-19 Vaccination Programme’ can be viewed on the journal website here.

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